Biomedical subjects
Publications and source records attributed to L J Jørgensen.
Solid papillary tumours of the pancreas are rare. The tumours are large and show a predilection for young women. There have been few reports of metastasizing tumours, but generally the prognosis is good after surgical removal. Three case histories are reported here.
Twenty-five synovial sarcomas were studied with a battery of antibodies directed against keratin and epithelial membrane antigen (EMA). The keratin antibody MNF 116 showed reactivity in 24 tumors. In addition, 22 tumors showed reactivity with the antibody Keratin Wide Spectrum, 20 with the antibody Keratin 56, 64, and 19 with CAM 5.2. Seventeen tumors showed reactivity with EMA. The keratin and EMA reactivity was present in cells lining obvious cleft-like structures in biphasic tumors. In the spindle cell areas of both biphasic and monophasic fibrous tumors, we found clusters of a few reacting cells apparently located around small clefts. In the synovioblastic tumors, clusters of plump tumor cells reactive for both the keratins and EMA were present. In conclusion, we found that proper identification of epithelial differentiation in synovial sarcomas is facilitated by an immunohistochemical application of anti-epithelial antibodies. In most tumors, there was immunoreactivity for the same type of keratins as are normally identified in simple epithelia (the antibody CAM 5.2), but also for those found in stratified squamous epithelia (the antibody Keratin 56, 64). The results indicate that screening for epithelial features on paraffin sections in the various types of synovial sarcoma, even the poorly differentiated synovioblastic tumors, is improved if epithelial antibodies with a broad spectrum of reactivity are chosen.
A case of a primary retroperitoneal mucinous cystadenocarcinoma in a 38-year-old female is presented. The literature concerning primary retroperitoneal cystadenocarcinomas is reviewed and it is concluded that close postoperative follow-up is necessary.
During the period 1962-1984, 26 cases of synovial sarcoma were seen in the center for bone and soft tissue tumours in Arhus, Denmark. None of the tumours were located in direct relation to bursa or joint cavities and the majority of the patients were initially operated in other hospitals and subsequently referred to the centre. Twenty-three patients were operable. Local excision was the primary treatment in 17 patients and amputation in six patients. Fourteen had local recurrence after an average of 12 months. At the status in June 1987, 14 patients had died of the disease, one survived with metastases to the lungs 30 months after the initial operation, one showed no evidence of disease after approximately three years, six patients were alive and without evidence of disease after at least five years. Five and ten-year survival rates for operable cases were 42% and 31%, respectively.
A case of hepatomegalia due to multiple metastases of unknown origin to the liver is described. At autopsy the primary tumor, an adenocarcinoid tumor of the appendix, was identified along with multiple metastases to the lymph nodes and widespread peritoneal carcinoidosis. Hepatic metastases from an appendiceal adenocarcinoid tumor has not been described previously. In the liver and lymph nodes the tumor had an insular growth pattern and was composed predominantly of cells of carcinoid type, whereas the carcinoidosis was composed almost entirely of signet-ring cells. It is suggested that differentiation of the metastases of appendiceal adenocarcinoids is modulated by factors in the recipient organ.
In two cases of solid and papillary neoplasm of the pancreas (SPN), positive staining for argyrophil granules, chromogranin-A, neuron-specific enolase, chymotrypsin, alpha 1-antitrypsin, vimentin, cytokeratin, and estrogen receptors was present. Ultrastructurally, neurosecretory as well as zymogenlike granules were demonstrated. Measurements of mean nuclear volume and volume-corrected mitotic index discriminated between SPN and well-differentiated ductal adenocarcinoma of the pancreas, with notably lower values being seen in SPN. Silver-stained nucleolar organizer region counts showed wide overlaps. The results suggest that SPN is a tumor with mixed endocrine and exocrine features. Its low malignant potential compared to ductal adenocarcinoma is reflected in the mean nuclear volume and volume-corrected mitotic index. The presence of estrogen receptors may prove therapeutically useful.